Original research BMJ Glob Health: first published as 10.1136/bmjgh-2016-000208 on 7 April 2017. Downloaded from Earned print media in advancing tobacco control in Himachal Pradesh, : a descriptive study

Renu Sharma,1 Hemant Deepak Shewade,1 Balasubramaniam Gopalan,1 Ramesh Kumar Badrel,2 Jugdeep Singh Rana1

To cite: Sharma R, ABSTRACT Key questions Shewade HD, Gopalan B, Background: The Union-Bloomberg Initiative tobacco et al . Earned print media in control projects were implemented in Himachal advancing tobacco control in What is already known about this topic? Pradesh (a hilly state in North India) from 2007 to Himachal Pradesh, India: ▸ Earned media is one of the strategies when there a descriptive study. BMJ 2014. The project focused on the establishment of an is limited funding available for effective imple- Global Health 2017;2: administrative framework; increasing the capacity of mentation of Framework Convention on Tobacco e000208. doi:10.1136/ stakeholders; enforcement of legislation; coalition and Control/Monitoring Tobacco Use, Protecting bmjgh-2016-000208 networking with multiple stakeholders; awareness People From Tobacco Smoke, Offering Help To generation with focus on earned media and monitoring Quit, Warning About Dangers Of Tobacco, and evaluation with policy-focussed research. This Enforcing A Ban On Tobacco Advertising And Received 8 October 2016 study aimed to systematically analyse all earned print Promotion, Raising Tax On Tobacco Products Revised 21 November 2016 news items related to the projects. policies. Accepted 22 December 2016 Methods: In this cross-sectional descriptive study, ▸ There is limited evidence of the role of earned quantitative content analysis of earned print news media in tobacco control, mostly from the west. items was carried out using predetermined codes related to areas of tobacco control policies. We also What are the new findings? carried out a cost description of the hypothetical value ▸ This is the first study to systematically analyse of this earned media. The area of the news item in cm2 all earned print news items associated with a was multiplied by the average rate of space for the paid tobacco control project in a state in North India. news item in that particular . ▸ The project was able to strategically use earned Results: There were 6348 news items: the numbers media to promote tobacco control policies: steadily increased with time. Focus on Monitoring hypothetical costs of earned media were more http://gh.bmj.com/ tobacco use, Protecting people from tobacco smoke, than the project itself. Offering help to quit, Warning about dangers of Recommendations for policy tobacco, Enforcing a ban on tobacco advertising and ▸ Earned media should be used as a strategy for promotion, Raising tax on tobacco products was seen an aware generation in tobacco control interven- in 24, 17, 9, 23, 22 and 3% of news items, tions/projects.

respectively. Press releases were highest at 44% and on September 28, 2021 by guest. Protected copyright. ▸ Earned media saves a significant amount of report by correspondents at 24%. Further, 55, 23 and costs. 21% news items focused on smoking, smokeless and both forms of tobacco use, respectively. Sixty-six per cent and 34% news items, respectively, were focused on youth and women. The news items had a communicable diseases.1 The WHO intro- hypothetical value of US$1503 628.3, which was three duced Monitoring tobacco use, Protecting times more than the funds spent on all project people from tobacco smoke, Offering help activities. to quit, Warning about dangers of tobacco, Conclusions: In the absence of funding for paid Enforcing a ban on tobacco advertising and 1International Union Against media, the project strategically used earned media to promotion, Raising tax on tobacco products Tuberculosis and Lung promote tobacco control policies in the state. measures (MPOWER) to assist in country- Disease (The Union), South- East Asia Office, , level implementation of effective interven- India tions to reduce the demand for tobacco, con- 2Himachal Pradesh Voluntary INTRODUCTION tained in the WHO’s Framework Convention Health Association (HPVHA), Reducing tobacco use is one of the most on Tobacco Control (WHO FCTC).2 Shimla, India effective strategies to help countries achieve India has an estimated 275 million tobacco Correspondence to the global targets set forth by the United users, which includes 111 million smokers. Dr Hemant Deepak Shewade; Nations Assembly in 2011 to propel India was the seventh country in the world to [email protected] the prevention and control of non- ratify WHO FCTC in February 2004. To

Sharma R, et al. BMJ Glob Health 2017;2:e000208. doi:10.1136/bmjgh-2016-000208 1 BMJ Global Health BMJ Glob Health: first published as 10.1136/bmjgh-2016-000208 on 7 April 2017. Downloaded from effectively control tobacco use in the country, the of news item: print release, report by correspondence, a Government of India enacted the comprehensive feature article, a column or an editorial; (3) MPOWER tobacco control legislation, namely ‘The Cigarettes and focus area: Monitor, Protect, Offer, Warn, Enforce, Raise Other Tobacco Products (Prohibition of Advertisement taxes; (4) focus area of tobacco control institutional and Regulation of Trade and Commerce, Production, infrastructure and framework as required under India’s Supply and Distribution) Act, 2003’.34India also tobacco control programme; (5) intent of news item: launched the National Tobacco Control Programme in whether antitobacco or protobacco and (6) hypothetical 2007 with mass media as an important component.5 costs saved as a result of using earned media. The role of mass media has been critical to the evolu- tion of effective tobacco control interventions in the 6 MATERIAL AND METHODS 21st century. While paid mass media campaigns can be Study design and study period expensive and unaffordable, they have been shown to be effective in a wide range of studies in tobacco This was a cross-sectional descriptive study of all earned – control.7 9 print news items related to The Union-BI tobacco Earned media is one of the strategies under article 12 control project activities which appeared in of FCTC guidelines on education, communication, train- across Himachal Pradesh (India) from Jul 2007 to Dec ing and public awareness.10 Earned media is defined as 2014. any publicity which has not been paid and that is owned and created by a third party.11 Traditionally, the term Setting ‘earned media’ has been used when publicity is gener- General setting: Himachal Pradesh is a state in North fl ated through public relations invested in targeting influ- India with a predominantly hilly terrain. It is anked by encers to increase awareness about a brand, online and/ Uttarakhand in the southeast, in the south, or offline.11 Earned media has not been used much in Punjab in the southwest and Jammu and Kashmir in the 15 tobacco control and most of the evidence is from the north. It is administratively divided into 12 districts. west, mostly dealing with increasing the demand for tele- According to the Global Adult Tobacco Survey India – phone or web-based quit lines71214 (2009), the prevalence of current tobacco use (any The International Union Against Tuberculosis and form) among adults is 21.2%: 38.5% among men and 3 Lung Disease (The Union) with support from the 3.7% among women. Bloomberg Initiative To Reduce Tobacco Use (BI) sup- Study setting: The Union-BI tobacco control project in ported tobacco control initiatives in a state in North Himachal Pradesh was implemented between 2011 and India through a civil society partner. In close collabor- 2014 through a civil society partner Himachal Pradesh ation with the National Tobacco Control Programme at Voluntary Health Association (HPVHA). Between July state and district levels, the project focussed on establish- 2007 and March 2011, there was only technical support ment of a politico-administrative and institutional frame- and very limited funding support (about US$10 000 in http://gh.bmj.com/ work; increasing capacity of stakeholders; enforcement 2010). An excellent collaboration between HPVHA and of legislation; coalition and networking with multiple sta- the State Department of Health and Family Welfare, keholders; awareness generation and monitoring and Government of Himachal Pradesh was instrumental in evaluation with policy-focused research. Since there was implementing the project work plan with regular onsite no funding for public education and awareness gener- and offsite technical support from The Union. ation including paid media, earned media in the form on September 28, 2021 by guest. Protected copyright. of print news items was used as a strategy for awareness Data collection generation on harms of tobacco, developing institutional The project staff of HPVHA, the civil society partner of framework, ensuring multistakeholder engagement, the project, did the data collection. A list of publicly highlighting violations and strengthening enforcement available print newspapers in the state (national, state of legislation. and local newspapers), with no language barrier, was There was anecdotal evidence that earned print media prepared. It was updated from time to time as the study was instrumental in generating an excellent support for period was over 8 years. As and when the print news project implementation and making inroads and pene- items related to project activities appeared, they were cut tration into semiurban and rural areas of this difficult and stored. This was done by staff at the district level terrain state. Considering the extent of the project, a sys- and state headquarters. We did not include online news tematic analysis of earned media provides us an oppor- items. tunity to understand how we used earned media and guide the use of the same in future tobacco control pro- Data analysis jects. Therefore, we aimed to systematically analyse the For objectives 1-5, quantitative descriptive content ana- trend, types of news items and hypothetical costs saved lysis of the print news items was done.616Each print through all earned print news items in the state during news item was given a unique serial number. The the project. Specific objectives were to describe the earned themes/codes were predetermined and the coders were print news items based on (1) year-wise trend; (2) type asked to classify the print news item under the following

2 Sharma R, et al. BMJ Glob Health 2017;2:e000208. doi:10.1136/bmjgh-2016-000208 BMJ Global Health BMJ Glob Health: first published as 10.1136/bmjgh-2016-000208 on 7 April 2017. Downloaded from themes/codes: MPOWER focus area (monitor, protect, Table 1 Characteristics of earned media (print news items) offer, warn, enforce, raise taxes); type of news item related to The Union-Bloomberg Initiative tobacco control (press release, correspondence, feature articles, column, project activities which appeared in newspapers across editorial, others); institutional system of tobacco control Himachal Pradesh, India, from Jul 2007 to Dec 2014 under focus (sensitisation/advocacy, awareness gener- Variable Number Percentage ation/information education and communication, legis- Total 6348 100 lation and enforcement, stakeholder engagement and Type of news item capacity building of stakeholders); intent of news item Press release 3817 60 (anti or protobacco); type of tobacco and age/gender Correspondence 1716 27 focus. These predetermined codes were identified after brainstorming among the investigators. We also looked Feature article 239 4 for tobacco industry (TI) interference (TII) and related A column 103 2 issues like illicit trade and corporate social responsibil- Editorial/op-ed* 65 1 ities (CSR). We also collected information on year of Others 408 6 publication; name and language of newspaper. Coding MPOWER focus area was done by the same staff that collected the print news Monitor 4033 64 item. They received training for coding from the union technical advisor (RJS). The coding process was ran- Protect 2867 45 domly supervised (10% of print news items) by the Offer 1386 22 supervisors at the state headquarters. Warn 3564 56 For objective 6, a cost description was undertaken to Enforce 3426 54 fi nd out the hypothetical value of this earned print Raise 396 6 media. The area of the news item in cm2 was multi- Focus on institutional system for tobacco control plied by the average rate of space per cm2 for a paid news item in that particular newspaper during the Sensitisation/advocacy of 1599 25 politico-administrative leadership year 2007 to 2014 (obtained in Indian rupee (INR) from the offices of the newspapers). The hypothetical IEC/awareness generation 2169 34 value of earned print media in INR was converted to Legislation mechanism and 3144 50 US$ at the average monthly value of US$ between enforcement 2008 and 2014 as the conversion factor. (US$1=INR Stakeholders’ engagements 2542 40 51.84). Capacity building of stakeholders 2475 39 Frequency and proportion was used to summarise the Intent of the news item analytic outputs using MS Excel.

Antitobacco 6232 98 http://gh.bmj.com/ Protobacco 130 2 Ethics Type of tobacco The need for ethics review for this study was waived off by the Ethics Advisory Group of The Union. Smoking 4063 64 Smoke less 479 8 Both 1862 28 RESULTS on September 28, 2021 by guest. Protected copyright. Age/gender focus A total of 26 newspapers had news items related to the project: 17 were in and nine in English. A total Children/youth 3529 56 of 6348 news items were published. Characteristics of Women 1642 26 these news items have been summarised in table 1.In *Opposite editorial. 2007–2008, there were only 51 items; it increased IEC, information education and communication; MPOWER, – Monitoring Tobacco Use, Protecting People From Tobacco Smoke, during 2010 2011 (1178 news items); and continuous Offering Help To Quit, Warning About Dangers Of Tobacco, improvement was seen until 2014 with 1687 news items Enforcing A Ban On Tobacco Advertising And Promotion, Raising (figure 1). Tax On Tobacco Products. Of the 6348 news items, 3816 (60%) were press releases and 1716 (27%) were correspondence. In terms of the MPOWER strategy, the media focused on all state. Further, 50, 40 and 39% news items focused on policy provisions: 64, 45, 22, 56, 50 and 6%, respectively enforcement of tobacco control laws, multistakeholder (there was some overlap of focus areas). Around 25% engagement and capacity building, respectively (there and 34% of media focus, respectively, was on sensitisa- was an overlap of categories). Further analysis revealed tion and advocacy of politico-administrative leadership that 6232 (98%) had an antitobacco theme, 4063 (64%) and awareness generation of general public about the dealt with smoking, 3529 (56%) news items focused on tobacco epidemic and need for strengthening and children/youth and 1642 (26%) focused on women. scaling up for prioritisation of tobacco control in the (Table 1) Around 1% of news items focused on TII,

Sharma R, et al. BMJ Glob Health 2017;2:e000208. doi:10.1136/bmjgh-2016-000208 3 BMJ Global Health BMJ Glob Health: first published as 10.1136/bmjgh-2016-000208 on 7 April 2017. Downloaded from 13% focused on illicit trade of tobacco products and a fragile and suboptimal approach of the government for few on CSR activities undertaken by TI (data not tobacco control in the state (data not shown). shown). Finally, 11% of the coverage also focused on the All the news items had a hypothetical cost of US $1503 628.3 (table 2).

DISCUSSION This is the first study worldwide to systematically analyse all earned print media associated with a tobacco control project, and the way in which the scale of this earned print media was described in the form of hypothetical costs saved is unique. Before this, a purposive sample of online earned media was studied,14 including the effect of earned media in relation to activities specificto tobacco cessation.71213We demonstrated how we used earned media strategically to further our cause of tobacco control in the state. The hypothetical value of fi Figure 1 Earned media print news items related to The earned print media (US$1503 628.3) was very signi cant Union-Bloomberg Initiative tobacco control project activities (more than three times higher) when compared with which appeared in newspapers across Himachal Pradesh, the total expenditure of the project funded by The India, year wise, from Jul 2007 to Dec 2014. Union under the BI grants programme (≈US$470 000).

Table 2 Cost description of earned media (print news items) related to The Union-Bloomberg Initiative tobacco control project activities which appeared in newspapers across Himachal Pradesh, India, from Jul 2007 to Dec 2014 Name of newspapers Language Total area in cm2 Rate @ INR/cm2 Amount (INR) Amount (US$)* Samachar Hindi 4391.32 35 153696.2 2964.8 Hindi 49760.64 333 16570293.1 319643.0 Apka Faisla Hindi 12732.78 55 700302.9 13508.9 Chamba Express Hindi 576 20 11520.0 222.2 Business English 356.17 85 30274.5 584.0 Daily Post English 387.02 75 29026.5 559.9 Hindi 18 259 125 2282375.0 44027.3 Dainik Jagaran Hindi 50926.65 504 25667031.6 495120.2 http://gh.bmj.com/ Dainik Tribune Hindi 566.55 95 53822.3 1038.2 Dainik Savera Hindi 1110 20 22200.0 428.2 Hindi 47748.75 90 4297387.5 82897.1 Encounter News Hindi 714 23 16422.0 316.8

Himachal Dastak Hindi 22596.66 45 1016849.7 19615.2 on September 28, 2021 by guest. Protected copyright. Himachal Plus English 1404.07 225 315915.8 6094.1 Times English 4349.17 787.5 3424971.4 66068.1 Indian Express English 307.55 500 153775.0 2966.3 Jansatta Hindi 96 240 23040.0 444.4 Pahli Khabar Hindi 103.2 55 5676.0 109.5 Panjab Kesari Hindi 85352.56 250 21338140.0 411615.4 Satya Swadesh Hindi 756 23 17388.0 335.4 Readers Digest English 195.5 30 5865.0 113.1 English 336 35 11760.0 226.9 English 3528.09 125 441011.3 8507.2 Times of India English 1865.3 671 1251616.3 24143.8 Himjan Awaz Hindi 3402 30 102060.0 1968.8 Dainik Nayay Setu Hindi 162 35 5670.0 109.4 Total 311982.98 77948089.9 1503628.3 *US$1=INR 51.84 (average monthly value of US$ between 2008 and 2014. INR, Indian rupee.

4 Sharma R, et al. BMJ Glob Health 2017;2:e000208. doi:10.1136/bmjgh-2016-000208 BMJ Global Health BMJ Glob Health: first published as 10.1136/bmjgh-2016-000208 on 7 April 2017. Downloaded from The study results are representative as all the news tobacco industry picked up and were highlighted by the items were studied with no purposive or random sam- media. A good number of news items also highlighted a pling. We used STrengthening the Reporting of fragmented and suboptimal approach of the state govern- OBservational studies in Epidemiology (STROBE) ment which helped in initiating corrective actions by the guidelines for conduct and dissemination of study find- government. The project was sensitive to the issue of ings.17 There were some limitations of this study. Each tobacco use among youth and women as suggested by the print news item was coded by one coder due to resource sufficient focus on child/youth and women (Table 1). constraints. The role of subjectivity, despite 10% being This earned print media revolution in the state rechecked, cannot be ruled out. It would be interesting reduced the financial burden in implementing various to consider who was likely to be reading these print project objectives and activities including enforcement news items including the socio-demographic character- of the legislation from 2008 to 2014. On the other hand, istics of readership. However, this literature is not avail- there was a huge rupee (dollar) gain on the investments able and was also beyond the scope of this study. for which the authors made a marathon effort to get a Evidence in tobacco control is limited regarding the rough hypothetical value. impact of earned print media coverage on behaviour, There is limited evidence of the role of earned media – and therefore we have to be careful in assuming that in tobacco control;71214 however, earned media com- newspaper coverage will have an impact on behaviour. mands an important place in marketing, business and During 2007–08, there were no regular project activ- other fields.20 21 It is often neglected because it is the ities. Limited print news items were due to occasional one communication tool that requires working closely activities done by HPVHA (figure 1). After that, the with the media and requires a good rapport, confidence increase in news items every year demonstrated the con- building and tangible relationships with journalists, and tinued engagement with the print media, increase in raising legitimate concern with evidence-based and activities under the project, increase in interest by news- truthful information.22 The same principles were fol- papers and increased multistakeholder engagement with lowed by the project. Though paid media has been time. Press release was the most common type of news shown to be effective in tobacco control, the advantage item. This showed that the project was proactive in of earned media lies in it being absolutely ‘free’ and media involvement for greater visibility. This was done getting something akin to a ‘third party’ testimonial.11 17 with support from the public relations officer of the gov- There are some risks and challenges in the public ernment, wherever possible, which added credibility to health community using earned media. There is lack of the project activities. Around one-third of the items were control and difficulty in measuring effectiveness and it correspondence; this meant that the newspaper corre- takes time, effort and requires investment in internal spondents and reporters were interested to cover the and external media content generation. There are also news and the same interest was shown by the editorial concerns about negative comments, misdirecting and board of the newspaper. The high proportion of news reshaping of the message. Further, social media tools are http://gh.bmj.com/ items dealing with the ‘M’ component of MPOWER already there and if earned media becomes more of a could be explained by the fact that a series of compli- focus, in times to come there would be a need for con- ance assessment studies were conducted in the state and sensus among the public health community on collec- widely disseminated.18 19 The focus was minimum on ‘R’ tion and assessment of data through social media (6%), perhaps because tobacco taxes were mainly the tools.14 mandate of the central government with a small compo- During the course of the project, the state-level moni- on September 28, 2021 by guest. Protected copyright. nent of value added tax which may be levied by the state toring committee and district-level monitoring commit- government. A majority of news items were against tees were constituted in all 12 districts of the state, with tobacco; this indicated that proper briefing of the media appointment of nodal officers. Enforcement teams/task with all scientific evidences, best practices and tobacco forces were established at the state, district and subdis- industry tactics was done to tilt media support in favour trict levels. Compliance with smoke-free laws ranged of tobacco control. As far as type of tobacco use was con- from 20% to 30% at baseline, which increased to cerned, around two-thirds of the news items highlighted around 85%. Advertisement and promotion of tobacco smoking forms of tobacco use, which was also the most products decreased in all the districts of the state and commonly used tobacco in the state as per the Global overall compliance rates increased from 24 to 82%. The Adult Tobacco Survey 2009.3 state of Himachal Pradesh was declared smoke free in There was all-round coverage of issues related to institu- July 2013 and progressed to become fully compliant tional systems for tobacco control. (Table 1) The focus with the country’s tobacco control legislation along with on establishing an institutional system is very important advancing other provisions of the MPOWER policy to ensure that tobacco control is sustainable and inte- package. During this process, the project strategically grated with multistakeholder engagement. Further, even used earned media. However, this being a descriptive in the early phase of tobacco control in the state, TII, study, the exact effect of earned print media on compli- illicit trade of tobacco products and CSR activities by ance cannot be ascertained.

Sharma R, et al. BMJ Glob Health 2017;2:e000208. doi:10.1136/bmjgh-2016-000208 5 BMJ Global Health BMJ Glob Health: first published as 10.1136/bmjgh-2016-000208 on 7 April 2017. Downloaded from Conclusion 3. Ministry of Health and Family Welfare; Government of India; – International Institute of Popularion Sciences. Global Adult Tobacco The Union BI tobacco control project, implemented in Survey India 2009–2010. New Delhi, India: Ministry of Health and collaboration with HPVHA and the state government, Family Welfare, Government of India, 2010. 4. Tobacco control division. Ministry of Health and Family Welfare. was able to strategically use earned print media on a Government of India. The Cigarettes and Other Tobacco Products large scale to promote tobacco control policies. (Prohibition of Advertisement and Regulation, Supply and Distribution) Act, 2003: 2015 amendment. New Delhi India. 2015. Handling editor Seye Abimbola. 5. National Tobacco Conrol Cell. Ministry of Health and Family Welfare. Government of India. Operational guidelines. National Tobacco Twitter Follow Hemant Shewade @HShewade Control Programme. New Delhi, India. 2012. 6. National Cancer Institute. Tobacco control monograph No. 19. The Acknowledgements The authors sincerely acknowledge the print media in role of the media in promoting and reducing tobacco use. Bethesda, Himachal Pradesh for their tremendous support provided for control of this MD: U.S. Department of Health and Human Services; National public health challenge in the state. We also acknowledge the project team of Institutes of Health. 2008. doi:NIH Pub. No. 07–6242. Himachal Pradesh Voluntary Health Association (HPVHA) led by Dr Narinder 7. Schillo BA, Mowery A, Greenseid LO, et al. The relation between media promotions and service volume for a statewide tobacco Sharma, Mr Shriniwas Joshi (honorary consultant for the project) and Mr quitline and a web-based cessation program. BMC public health Sudhanshu S Dogra for collecting, collating and analysing the print media 2011;11:939. coverage and Dr Gopal Chauhan and Dr Ravinder Kumar of the Department of 8. Farrelly MC, Davis KC, Nonnemaker JM, et al. Promoting calls to a Health and Family Welfare, Government of Himachal Pradesh for providing quitline: quantifying the influence of message theme, strong negative support and leadership to implement various tobacco control initiatives in the emotions and graphic images in television advertisements. Tob – state. We acknowledge the Bloomberg Initiative to Reduce Tobacco Use for Control 2011;20:279 84. 9. Farrelly MC, Hussin A, Bauer UE. Effectiveness and cost financial support to HPVHA for establishing, strengthening and sustaining effectiveness of television, radio and print advertisements in tobacco control in the state. Finally, we thank the Department for International promoting the New York smokers’ quitline. Tob Control 2007;16 Development, UK, for funding the Global Operational Research Fellowship (Suppl 1):i21–3. Programme at the International Union Against Tuberculosis and Lung Disease 10. World Health Organization (WHO). Guidelines for implementation of (The Union), Paris, France in which Dr Hemant Deepak Shewade works as a Article 12. 2016. http://www.who.int/fctc/guidelines/adopted/article_ senior operational research fellow. 12/en/ (accessed 17 Nov 2016). 11. Yu J. Earned media rising—the earned media ripple effect. 2013. Contributors RS was the principal investigator; RJS was the senior author; http://marketingland.com/earned-media-rising-the-earned-media- RKB was the site investigator who collected and collated print news items; RS ripple-effect-56528 (accessed 6 Jun 2016). 12. Deprey M, McAfee T, Bush T, et al. Using free patches to improve and RJS conceived and designed the protocol; RS, HDS, BG and RKB reach of the Oregon Quit Line. J Public Health Manag Pract developed the tools and plan of analysis; RS prepared the first draft of the 2009;15:401–8. manuscript; HDS provided expert support to write and refine the manuscript; 13. Sheffer MA, Redmond LA, Kobinsky KH, et al. Creating a perfect all authors were involved in critically reviewing the paper and giving approval storm to increase consumer demand for Wisconsin’s Tobacco – for the final version to be published. Quitline. Am J Prev Med 2010;38:S343 6. 14. Kornfield R, Smith KC, Szczypka G, et al. Earned media and public Funding The study was conducted as an operational research under the engagement with CDC’s ‘Tips from former smokers’ campaign: an project conditions using project staff. Therefore, no separate budget was analysis of online news and blog coverage. J Med Internet Res required. The submission of the paper to an open access journal was 2015;17:e12. 15. Government of India. Ministry of Home Affairs. Office of Registrar supported by funds from The International Union Against Tuberculosis and General and Census Commissioner. Census of India. 2011. http:// Lung Disease (The Union), South-East Asia Office. www.censusindia.gov.in/2011-common/census_2011.html

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6 Sharma R, et al. BMJ Glob Health 2017;2:e000208. doi:10.1136/bmjgh-2016-000208